Provider Demographics
NPI:1417955998
Name:SHERER, RYAN J (MD)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:J
Last Name:SHERER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7240 S US HIGHWAY 231
Mailing Address - Street 2:
Mailing Address - City:HUNTINGBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47542-9450
Mailing Address - Country:US
Mailing Address - Phone:812-683-9020
Mailing Address - Fax:812-683-9024
Practice Address - Street 1:7240 S US HIGHWAY 231
Practice Address - Street 2:
Practice Address - City:HUNTINGBURG
Practice Address - State:IN
Practice Address - Zip Code:47542-9450
Practice Address - Country:US
Practice Address - Phone:812-683-9020
Practice Address - Fax:812-683-9024
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01055642A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200373390Medicaid
IN000000338341OtherANTHEM
IN200859330KOtherMEDICAID GROUP
IN200373390Medicaid
IN200859330KOtherMEDICAID GROUP
IN200373390Medicaid